Tuesday 28 June 2011 07.00 EDT
First published on Tuesday 28 June 2011 07.00 EDT

Housed in a nondescript building among a row of shops, Camden Psychotherapy Unit (CPU) is a small community-based voluntary mental health service providing long-term psychotherapy for residents of Camden, in north London. A typical patient might have long-standing problems with depression or anxiety that antidepressants or less intensive "talking therapies" such as cognitive behaviour therapy have failed to address.

It treats around 80 patients a year, most of whom are on low incomes or on benefits and would not be able to afford this kind of treatment privately. Many are self-referrals, for whom the long waiting lists for therapy in the statutory sector are a major hurdle to recovery, says unit head Ora Dresner. Because CPU is not in a traditional clinical setting, vulnerable people, who would find the "institutionalised" environment of hospitals intimidating, feel comfortable approaching, she adds.

Dresner, who has been at CPU for almost two decades says the service, which is now threatened with closure, plugs a gap in statutory provision.

The unit costs £7,000 a month to run – just £33 per counselling session. But last autumn it learned that, due to changes in local commissioning of psychological services, its funding from Camden primary care trust would be withdrawn from the end of this month. Since then, local GPs, senior psychiatrists and former patients have tried to save the centre.

CPU supporters say that amid efforts by health bodies to calibrate services in the face of cuts and reorganisation of provision of therapies, some voluntary organisations no longer slot into new commissioning criteria.

As a small, specialist voluntary sector service, Dresner says CPU is "not in a position" to apply for funding under the new tender requirements. She approached a large bidder, Camden and Islington NHS foundation trust, suggesting CPU become a partner in its bid, but was unsuccessful.

Campaigners argue that concerns about closures and cutbacks are being echoed in small voluntary organisations across the country and it would be wrong to see the problems faced by CPU as some kind of inevitable, if regrettable, fallout of restructuring health provision.

Robin Anderson, a consultant psychiatrist, says the threatened loss of small services need to have a spotlight shone on them because they are often innovative linchpins in an otherwise inflexible, monolithic system. "Commissioning is an issue. There are massive cuts across the health service. It's a tough time and the weak go against the wall. You get to a point where [an organisation] doesn't fit in to the structure."

David Bell, president of the British Psychoanalytic Society, says services like CPU are a crucial part of the broader fabric of services and that when they disappear an already overstretched mental health system is put under even more pressure.

"Mental health services in general are seriously underfunded and there is a scarcity of the kinds of therapy that CPU provides.

"Here is a service that grew up organically from its community. Many of the people who go to CPU would find other services alien. It is staffed by highly qualified professionals and has a very low drop-out rate. It provides for an underserved portion of the population and it stands as a beacon for good, local services. Once it's gone you can't re-establish it," he says.

Seven years ago, a counsellor at Benedict Vallis' GP's surgery suggested that she needed long-term, intensive therapy and recommended CPU. "It was a lifeline for me. Simple as that," Vallis says. "From the moment I was there I felt supported. I felt I was part of something that would make a difference in my life, and it did."

Dresner hopes to stretch resources at CPU to allow it to operate for another year, while trying to raise funds from alternative sources. She says: "If we close, a choice will have been taken away from people who really need it. It would be a tragedy."